Individual
LESLIE KIDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9038 CROSS PARK DR STE 105, KNOXVILLE, TN 37923-4729
(865) 394-6612
(865) 315-7014
Mailing address
9038 CROSS PARK DR STE 105, KNOXVILLE, TN 37923-4729
(865) 394-6612
(865) 315-7014
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-22-58298
TN
106S00000X
Behavior Technician
RBT-15-04531
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-22-58298
BACB
TN
01
—
RBT-15-04531
BACB
IN
Enumeration date
11/12/2021
Last updated
03/01/2022
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